Risk factors for 30-day hospital readmission after radical gastrectomy: a single-center retrospective study

Raito Asaoka, Taiichi Kawamura, Rie Makuuchi, Tomoyuki Irino, Yutaka Tanizawa, Etsuro Bando, Masanori Terashima

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Hospital readmission is gathering greater attention as a measure of health care quality. The introduction of fast-track surgery has led to shorter lengths of hospitalization without increasing the risk of postoperative complications and readmission. The collection of comprehensive readmission data is essential for the further improvement of patient care. The aim of the present study is to evaluate the risk factors for readmission within 30 days of discharge after gastrectomy. Methods: A total of 1929 patients who underwent radical gastrectomy at Shizuoka Cancer Center were included in this study. A risk analysis with a stepwise logistic regression model was conducted to identify the risk factors for 30-day hospital readmission. Results: The 30-day readmission rate was 2.70%. Common causes of readmission were an intolerance of oral intake and the presence of an intra-abdominal abscess. The C reactive protein (CRP) level on postoperative day (POD) 3 was significantly higher in the readmitted group; however, the other surgical outcomes, including the incidence of postoperative complications, did not differ to a statistically significant extent. The stepwise logistic regression analysis revealed that CRP on POD3 ≥ 12 mg/dl [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.09–3.95, p = 0.025], laparoscopic surgery (OR 2.25, 95% CI 1.17–4.31, p = 0.015), and TG (OR 2.23, 95% CI 1.17–4.78, p = 0.023) were found to be independent risk factors for readmission. Conclusions: CRP on POD3 ≥ 12 mg/dl, laparoscopic surgery, and TG were identified as independent risk factors for readmission.

Original languageEnglish
Pages (from-to)413-420
Number of pages8
JournalGastric Cancer
Volume22
Issue number2
DOIs
Publication statusPublished - 2019 Mar 15
Externally publishedYes

Fingerprint

Patient Readmission
Gastrectomy
Retrospective Studies
C-Reactive Protein
Logistic Models
Odds Ratio
Confidence Intervals
Laparoscopy
Abdominal Abscess
Quality of Health Care
Patient Care
Hospitalization
Regression Analysis
Incidence
Neoplasms

Keywords

  • Gastric cancer
  • Hospital readmission
  • Radical gastrectomy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Risk factors for 30-day hospital readmission after radical gastrectomy : a single-center retrospective study. / Asaoka, Raito; Kawamura, Taiichi; Makuuchi, Rie; Irino, Tomoyuki; Tanizawa, Yutaka; Bando, Etsuro; Terashima, Masanori.

In: Gastric Cancer, Vol. 22, No. 2, 15.03.2019, p. 413-420.

Research output: Contribution to journalArticle

Asaoka, R, Kawamura, T, Makuuchi, R, Irino, T, Tanizawa, Y, Bando, E & Terashima, M 2019, 'Risk factors for 30-day hospital readmission after radical gastrectomy: a single-center retrospective study', Gastric Cancer, vol. 22, no. 2, pp. 413-420. https://doi.org/10.1007/s10120-018-0856-4
Asaoka, Raito ; Kawamura, Taiichi ; Makuuchi, Rie ; Irino, Tomoyuki ; Tanizawa, Yutaka ; Bando, Etsuro ; Terashima, Masanori. / Risk factors for 30-day hospital readmission after radical gastrectomy : a single-center retrospective study. In: Gastric Cancer. 2019 ; Vol. 22, No. 2. pp. 413-420.
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T2 - a single-center retrospective study

AU - Asaoka, Raito

AU - Kawamura, Taiichi

AU - Makuuchi, Rie

AU - Irino, Tomoyuki

AU - Tanizawa, Yutaka

AU - Bando, Etsuro

AU - Terashima, Masanori

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N2 - Background: Hospital readmission is gathering greater attention as a measure of health care quality. The introduction of fast-track surgery has led to shorter lengths of hospitalization without increasing the risk of postoperative complications and readmission. The collection of comprehensive readmission data is essential for the further improvement of patient care. The aim of the present study is to evaluate the risk factors for readmission within 30 days of discharge after gastrectomy. Methods: A total of 1929 patients who underwent radical gastrectomy at Shizuoka Cancer Center were included in this study. A risk analysis with a stepwise logistic regression model was conducted to identify the risk factors for 30-day hospital readmission. Results: The 30-day readmission rate was 2.70%. Common causes of readmission were an intolerance of oral intake and the presence of an intra-abdominal abscess. The C reactive protein (CRP) level on postoperative day (POD) 3 was significantly higher in the readmitted group; however, the other surgical outcomes, including the incidence of postoperative complications, did not differ to a statistically significant extent. The stepwise logistic regression analysis revealed that CRP on POD3 ≥ 12 mg/dl [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.09–3.95, p = 0.025], laparoscopic surgery (OR 2.25, 95% CI 1.17–4.31, p = 0.015), and TG (OR 2.23, 95% CI 1.17–4.78, p = 0.023) were found to be independent risk factors for readmission. Conclusions: CRP on POD3 ≥ 12 mg/dl, laparoscopic surgery, and TG were identified as independent risk factors for readmission.

AB - Background: Hospital readmission is gathering greater attention as a measure of health care quality. The introduction of fast-track surgery has led to shorter lengths of hospitalization without increasing the risk of postoperative complications and readmission. The collection of comprehensive readmission data is essential for the further improvement of patient care. The aim of the present study is to evaluate the risk factors for readmission within 30 days of discharge after gastrectomy. Methods: A total of 1929 patients who underwent radical gastrectomy at Shizuoka Cancer Center were included in this study. A risk analysis with a stepwise logistic regression model was conducted to identify the risk factors for 30-day hospital readmission. Results: The 30-day readmission rate was 2.70%. Common causes of readmission were an intolerance of oral intake and the presence of an intra-abdominal abscess. The C reactive protein (CRP) level on postoperative day (POD) 3 was significantly higher in the readmitted group; however, the other surgical outcomes, including the incidence of postoperative complications, did not differ to a statistically significant extent. The stepwise logistic regression analysis revealed that CRP on POD3 ≥ 12 mg/dl [odds ratio (OR) 2.08, 95% confidence interval (CI) 1.09–3.95, p = 0.025], laparoscopic surgery (OR 2.25, 95% CI 1.17–4.31, p = 0.015), and TG (OR 2.23, 95% CI 1.17–4.78, p = 0.023) were found to be independent risk factors for readmission. Conclusions: CRP on POD3 ≥ 12 mg/dl, laparoscopic surgery, and TG were identified as independent risk factors for readmission.

KW - Gastric cancer

KW - Hospital readmission

KW - Radical gastrectomy

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